Abstract: Methods and apparatus are provided for removing emboli during an angioplasty, stenting or surgical procedure comprising a catheter having an occlusion element, an aspiration lumen, and a blood outlet port in communication with the lumen, a guide wire having a balloon, a venous return sheath with a blood inlet port, and tubing that couples the blood outlet port to the blood inlet port. Apparatus is also provided for occluding the external carotid artery to prevent reversal of flow into the internal carotid artery. The pressure differential between the artery and the vein provides reverse flow through the artery, thereby flushing emboli. A blood filter may optionally be included in-line with the tubing to filter emboli from blood reperfused into the patient.

Abstract: A suture trimmer having a shaft with a groove formed in the side thereof, a cutting member movably disposed within the shaft, and a suture retainer slidably disposed within the shaft. The suture trimmer may be used to position knots formed within a suture loop prior to trimming the free end(s) of the suture loop, and to deliver an agent near the location where the suture is severed.

Abstract: An electric-powered device includes (1) a skin-contactable surface and (2) a body having a water-resistant switch assembly. Preferably, the electric-powered device is useful in skin treatment and delivers mechanical forces on the skin. The switch assembly preferably includes, a substantially planar mount having an aperture, a rotatable shaft extending through the aperture, and a seal lining the aperture to restrict water movement along the shaft.

Abstract: Disclosed is an expandable percutaneous sheath, for introduction into the body while in a first, low cross-sectional area configuration, and subsequent expansion to a second, enlarged cross-sectional configuration. The sheath is maintained in the first, low cross-sectional configuration by a removable tubular restraint. In one application, the sheath is utilized to introduce a formed in place orthopedic fixation rod such as for use in spinal fixation procedures.

Abstract: Methods and devices are provided for effecting movement of one or more components of a multifire device, such as a clip applier, hernia tacker, or skin stapler. In one exemplary embodiment, a surgical fastening instrument is provided having an elongate shaft with an end effector coupled thereto and adapted to apply one or more surgical fasteners to tissue. An electrically expandable and contractible actuator, such as an electroactive polymer actuator, can be used to drive a fastener advancing or forming assembly through the elongate shaft, thereby driving a surgical fastener into tissue. In another embodiment, an electrically expandable and contractible actuator, such as an electroactive polymer actuator, can be used to effect movement of an articulation joint formed between the elongate shaft and the end effector.

Abstract: This document discusses trajectory guides that include an instrument guide with at least one lumen angled with respect to an orthogonal or other through-axis. In one example, patterned lumens on the instrument guide provide a mirror image pattern of trajectory axes intersecting a target plane. In another example, height adjustment of the instrument guide extends these or other targeting techniques to a three-dimensional volume. This document also describes a method of manufacturing such an instrument guide, which is also applicable to manufacturing an instrument guide providing parallel lumens.

Abstract: The present disclosure relates to a sheath system for enabling access through an opening in the body of a patient is provided. The sheath system includes a dilation assembly having a radially expandable tubular sheath defining a lumen having a first cross-sectional area when in a non-expanded condition, and a handle assembly operatively coupled to a proximal end of tubular sheath, the handle assembly defining an aperture formed therein, and a first thread defined on the handle in the aperture thereof. The sheath system further includes an expansion assembly including a tubular member defining a lumen having a second cross-sectional area which is larger than the first cross-sectional area of the tubular sheath of the dilation assembly and having an outer surface defining a second thread, the second thread being arranged for engaging the first thread.

Abstract: A locking component delivers and locks an attached medical device along a pre-deployed guide wire. The locking component can lock onto a flexible body member disposed on the guide wire, such as the distal helical tip coil of a conventional guide or a specially-designed guide wire. The locking component includes a tapered opening which temporarily compresses a portion of the helical coil and a locking recess in communication with the tapered opening for receiving the compressed coil. Compressed coils which enter the locking recess will spring back to their original shape (diameter) within the locking recess, locking the component to the coil.

Abstract: Methods and devices are provided for actuating and/or articulating a grasping device. In one exemplary embodiment, a grasping device is provided having a shaft with an end effector having opposed jaws coupled to the shaft. An electrically expandable and contractible actuator, such as an electroactive polymer actuator, can be used to actuate the end effector to open and close the opposed jaws to grasp tissue or other objects. In another embodiment, an electroactive polymer actuator can be used to pivotally or angularly adjust a position of the end effector relative to the shaft by delivering energy to the electroactive polymer actuator.

Abstract: Surgical methods and related medical devices for treating glaucoma are disclosed. The method comprises trabecular bypass surgery, which involves bypassing diseased trabecular meshwork with the use of a stent implant. The stent implant is inserted into an opening created in the trabecular meshwork by a piercing member that is slidably advanceable through the lumen of the stent implant for supporting the implant insertion. The stent implant is positioned through the trabecular meshwork so that an inlet end of the stent implant is exposed to the anterior chamber of the eye and an outlet end is positioned into fluid collection channels at about an exterior surface of the trabecular meshwork or up to the level of aqueous veins.

Abstract: Venous filters having at least two struts (110) each having a connected end and a non-connected end, wherein each of the struts includes a strut portion and an anchor portion (116), and wherein the strut portion and the anchor portion are attached via an electrolytically active thread (221, 222); and a head (118) that connects the connected ends of the struts, wherein the strut portion can be separated from the anchor portion at least in part by the application of an electrical current. The invention also includes a venous filter having at least two struts, wherein each of the struts includes a temperature sensitive portion and an anchor portion; wherein the anchor portion is separated from the temperature sensitive portion at least in part by changing the temperature around at least the temperature sensitive portion.

Abstract: Methods and devices are provided for actuating and/or articulating a grasping device. In one exemplary embodiment, a grasping device is provided having a shaft with an end effector having opposed jaws coupled to the shaft. An electrically expandable and contractible actuator, such as an electroactive polymer actuator, can be used to actuate the end effector to open and close the opposed jaws to grasp tissue or other objects. In another embodiment, an electroactive polymer actuator can be used to pivotally or angularly adjust a position of the end effector relative to the shaft by delivering energy to the electroactive polymer actuator.

Abstract: The invention relates to a medical grasping and holding instrument with a handle consisting of two handgrips and with a holding portion that consists of at least two jaw members and can be activated by the handle. The jaw members of the holding portion can be locked by means of a spring element both in an end position that releases the holding portion and in an end position that locks the holding portion. In order to create a medical grasping and holding instrument that is of simple construction, can be operated with just one hand, and is easy to clean, it is proposed with this invention that the spring element, configured as a flat spring, for locking the jaw members in their end positions is mounted between the handgrips of the handle so as to connect the two handgrips to one another in such a way that the spring element can be moved by way of a bearing point of a handgrip at the spring element between two end positions that release the spring element.

Abstract: A pressure support system and method of treating disordered breathing that optimizes the pressure delivered to the patient to treat the disordered breathing while minimizing the delivered pressure for patient comfort. The controller in the pressure support system operates as a set of prioritized control layers, wherein each control layer competes for control of the pressure generating system to implement a unique pressure control process. The pressure support system also controls the pressure provided to the patient based on the variability of the monitored data and a trend analysis of this data, including an indication of the skewness of the patient's inspiratory waveform.

Abstract: A locking device that can be used to adjust a cord of a small system or a medical device. The locking device includes an outer housing having a first lumen. A cord is disposed within the first lumen where the cord is freely moveable through the first lumen. A locking mechanism is disposed within the first lumen and over the cord. The locking mechanism is configured to lock or unlock the cord relative to the outer housing. An actuator is configured to move the locking mechanism to lock or unlock the cord relative to the outer housing.

Abstract: A fastener including at least an element to be anchored in an anatomical support, at least a stop element relative to a planar prosthetic component to be fixed, and a linking rod is characterised in that the linking rod is rectilinear and the junction zones of the anchoring element and the stop element with the linking rod enable the fastener to adopt: a non-stressed stripping configuration; a maximum stress configuration, doubled up on itself, for example in a tubular configuration by complete insertion of the fastener into a tube, and a minimum stress configuration, wherein the respective directions of the stop element and the anchoring element form between them, for example in the same plane, an angle not greater than 90°.

Abstract: The present invention relates to methods and articles for anchoring within a natural bodily lumen. An anchor is adapted to provide differing radially-outward forces along its length, a securing force and a transitional force. Production of these forces can be controlled by varying a physical property of the anchor, such as its stiffness, thickness, or shape. For example, the stiffness of an elongated anchor can be varied from a relatively soft value at its proximal and distal ends to a relatively stiff value at its center by varying the diameter of wire forming the anchor, thereby tailoring it to an intended application. Such force tailoring can be combined with external barbs and used to reliably anchor other instruments, such as feeding tubes and intestinal sleeves.

Abstract: The present invention relates generally to perfusion catheters and distal protection devices. According to an embodiment, the present invention includes a distal protection filter comprising an elongate shaft having a proximal end and a distal end, a distal protection device disposed at the distal end, a coupling member that couples the elongate shaft to the distal protection device, and a first space between the coupling member and the elongate shaft. A method of filtering debris from a blood vessel is also disclosed.

Abstract: A microkeratome 10 for use in ophthalmic surgery includes a bar-link drive 20 connected to a cutting-head 36. A fixation ring 34 attaches to a patient's eye and is coupled to the bar-link drive 20 to the drive the cutting-head 36 at least partially across the fixation ring 34.

Abstract: A holding member has an opening portion which opens to an distal end. The opening portion, the distal end of an endoscope and a holding member define a treatment space. A clamping member can project and retreat from and into the opening portion through the treatment space. The puncture member can move in the treatment space, in a direction that intersects with the longitudinal direction of the endoscope.